Gynecologist appointment price
Consultation with a gynecologist of the highest qualification category with the primary purpose of treatment
1800 rub.
Emergency contraception is one of the least harmful ways to prevent pregnancy after unprotected sexual intercourse. The very name of this procedure suggests that resorting to it often is at least undesirable. Some couples from time to time forget about the need to take care of contraception. This is where emergency contraception comes to the rescue.
First of all, you should determine on what day of the menstrual cycle sexual intercourse took place. In the first and last weeks of the menstrual cycle, it is quite possible to stop taking medications, because ovulation occurs in the middle of the cycle. This rule applies exclusively to those representatives of the fair sex whose menstrual cycle is regular.
The consequences of taking emergency contraception can be extremely unpleasant, so you should not use them unless necessary. You should not take emergency contraception during scheduled use of hormonal contraceptives (in the first weeks, when the contraceptive effect is still low). During this period, it is better to use non-hormonal agents. It is also not recommended to use emergency contraception while breastfeeding.
If you had unprotected sex and you think there is a possibility of pregnancy, but you are not ready for it now? Just call us! Choose the clinic closest to you and make an appointment with a gynecologist. Our phones:
- Clinic on Shchelkovskaya 8 (495) 221-21-14 (Eastern Administrative District: Izmailovo, Golyanovo, Pervomaiskaya, Shchelkovskaya, Partizanskaya)
- Clinic in Tekstilshchiki 8 (499) 322-23-97 (South-Eastern Administrative District: Volgogradsky Prospekt, Ryazansky Prospekt, Lyublino, Kuzminki, Pechatniki)
- Clinic in Maryina Roshcha 8 (495) 221-21-16 (NEAD: VDNH, Savelovskaya, Rizhskaya, Alekseevskaya, Sushchevsky Val)
- Clinic in Mitino 8 (495) 212-90-47 (Northwest Administrative District: Pyatnitskoye Highway, Mitino, Dubravnaya, Pavshino, Pavshinskaya Poyma, Krasnogorsk)
Types of postcoital contraceptives
Tablets that prevent unwanted pregnancy are produced based on two active ingredients:
- levonorgestrel is a hormonal substance from the group of gestagens, an analogue of progesterone;
- Mifepristone is a steroidal antiprogestogen substance.
These components differ in their mechanism of action. Levonorgestrel is a substance that acts similarly to endogenous progesterone, but has an anti-estrogenic effect. If taken before ovulation, it inhibits ovulation by suppressing the release of pituitary hormones LH and FSH. The egg does not mature, fertilization becomes impossible.
If you take birth control within 72 hours of ovulation, your risk of getting pregnant is higher. But levonorgestrel causes thickening of the cervical mucus, leading to changes in the endometrium that do not allow the embryo to implant.
The mechanism of action of mifepristone is different. It has an antiprogestagenic effect and blocks progesterone receptors in the endometrium. This increases the contractility of the myometrium. At the same time, there is an increase in the synthesis of prostaglandins, which increase the lumen of the cervical canal and also increase contractions of the muscle cells of the uterus. The fertilized egg cannot implant and leaves the organ cavity.
Sources
- Kaller S., Mays A., Freedman L., Harper CC., Biggs MA. Exploring young women's reasons for adopting intrauterine or oral emergency contraception in the United States: a qualitative study. // BMC Womens Health - 2021 - Vol20 - N1 - p.15; PMID:31992295
- Nara R., Banura A., Foster AM. Assessing the availability and accessibility of emergency contraceptive pills in Uganda: A multi-methods study with Congolese refugees. // Contraception - 2020 - Vol101 - N2 - p.112-116; PMID:31655072
- El-Mowafi IM., Foster AM. Emergency contraception in Jordan: Assessing retail pharmacists' awareness, opinions, and perceptions of need. // Contraception - 2021 - Vol101 - N4 - p.261-265; PMID:31655070
- Rokicki S., Merten S. The context of emergency contraception use among young unmarried women in Accra, Ghana: a qualitative study. // Reprod Health - 2021 - Vol15 - N1 - p.212; PMID:30567545
- Puig Borràs C., Álvarez Álvarez BI. The history of universal access to emergency contraception in Peru: a case of politics deepening inequalities. // Reprod Health Matters - 2021 - Vol26 - N54 - p.47-50; PMID:30475160
- Hamdaoui N., Cardinale C., Agostini A. [Emergency contraception: CNGOF Contraception Guidelines]. // Gynecol Obstet Fertil Senol - 2021 - Vol46 - N12 - p.799-805; PMID:30389544
- Kurian A., Kaushik K., Subeesh V., Maheswari E., Kunnavil R. Safety Profile of Levonorgestrel: A Disproportionality Analysis of Food and Drug Administration Adverse Event Reporting System (Faers) Database. // J Reprod Infertil - 2021 - Vol19 - N3 - p.152-156; PMID:30167396
- Pem D., Nidup T., Wangdi U., Pelzom D., Mirzazadeh A., McFarland W. Emergency Contraceptive Pills (ECP) Knowledge, Attitudes, and Practices Among Women Working in the Entertainment Industry and Men in the Trucking Industry, Bhutan . // AIDS Behav - 2018 - Vol22 - NSuppl 1 - p.121-124; PMID:29435794
- Ambrus T., Kolář J., Krempaská R. . // Ceska Slov Farm - 2021 - Vol65 - N5 - p.176-181; PMID:28073280
- Dunn S., Guilbert E. Contraception d'urgence. // J Obstet Gynaecol Can - 2021 - Vol38 - N12S - p.S143-S152; PMID:28063529
Review of emergency contraceptives 72 hours
The pills, which are used to prevent conception after sexual intercourse, can be purchased without a doctor's prescription. They can be used by women of fertile age over 18 years of age. Such hormonal drugs are not recommended for adolescents.
№1 Postinor
A progestogen drug for immediate protection, which includes a single dose of 0.75 mg levonorgestrel. The Postinor blister contains 2 tablets, which are divided into 2 doses . You can take the entire dose at one time if the woman is in the middle of her menstrual cycle and there is no high probability of ovulation within a few hours after sex. The cost of a pack is 310-342 rubles.
No. 2 Escapelle
The drug Escapel contains the active ingredient levonogrestrel, but in an increased dose of 1.5 mg. For contraception, one tablet is taken, which cannot be divided or crushed. Repeated administration of the medicine is required only in case of vomiting in the next 2-3 hours. Price 382-406 rub.
Attention! A large dosage of the hormone increases the likelihood of adverse reactions. Levonorgestrel in such quantities may exhibit weak androgenic properties.
No. 3 Genale
Zhenale birth control pills are based on mifepristone. A single dose is 10 mg. It is enough to increase myometrial contractility and prevent implantation of the fertilized egg. But as the dose increases, the risk of adverse reactions increases. To terminate pregnancy, analogues of Zhenale are used, but with a concentration of the active substance 60 times higher. The average price of emergency contraception is 450 rubles.
No. 4 Eskinor-F
The package contains 2 tablets based on levonogrestrel. It is recommended to use them no more than once during the cycle. But emergency contraception does not replace the subsequent use of condoms.
Eskinor-F, like other drugs in its group, can cause intermenstrual bleeding and cycle disruption. Therefore, it is better to resort to this method of protection against pregnancy as a last resort. The cost of tablets is on average 350 rubles.
No. 5 Gynepriston
Tablets with mifepristone in a dosage of 0.01 g. Prevent implantation of the embryo into the uterine wall.
It is recommended to take them 2 hours before meals or 2 hours before meals to increase the contraceptive effect. The package can contain 1 or 2 tablets. Women who have had more than 24 hours after unprotected sex, or who are in the middle of their menstrual cycle, should take a double dose.
No. 6 Modell 911
Levonorgestrel tablet at a dose of 1.5 mg, the package contains 1 piece. Research shows that this drug is highly effective and helps prevent pregnancy in 84% of cases. If you use 2 tablets of 0.75 mg with an interval of 12 hours, the chances of not getting pregnant are reduced to 79%. The cost of packaging is about 400 rubles.
How effective is it?
It is impossible to predict the time of ovulation, so the pill should be taken as soon as possible after unprotected sex.
In an open-label clinical trial of women receiving the emergency contraception ulipristal acetate (ellaOne) between 48 and 120 hours after unprotected intercourse, the pregnancy rate was 2.1%.
The effectiveness of the pill may decrease as weight or body mass index increases, but all women should take emergency contraception as soon as possible.
In addition, there are many interactions between the tablet and other medications that may affect the concentration of the active substance in the body. Before taking emergency contraception, you should carefully read the instructions for the drug.
In any case, one pill every other day may not be as effective as regular contraception and should never be replaced.
In addition, it does not protect against sexually transmitted diseases.
Rules for using birth control pills 72 hours
To avoid getting pregnant, you need to take the pill within 72 hours after sexual intercourse. The first is drunk as early as possible, the second - 12 hours after the first. The sooner the first dose is taken, the more likely it is that it will have time to work. In some cases, it is possible to take 2 tablets at the same time. If vomiting occurs after 3 hours, a repeat dose must be taken .
The time limit for using the pills is strictly specified; it is useless to use contraceptives within a week after sexual intercourse. After 72 hours, the contraceptive effect disappears, because the embryo manages to exit into the uterine cavity.
Recommendations for use do not differ from the active ingredient of the drug: the dosage regimen is the same for levonorgestrel and mifepristone.
Features of use during lactation
Rapid-acting emergency contraceptives are well tolerated by nursing mothers even in the absence of menstruation. Both drugs pass into breast milk but have different rates of metabolism. You can continue breastfeeding after taking levonorgestrel-based tomorrow pills after 24 hours, expressing milk during this time. Those who have used mifepristone should abstain for 14 days. Therefore, levonorgestrel-based drugs are recommended for nursing mothers.
Postcoital contraception - principle of action and effectiveness
All drugs in this group are hormonal. The principle of their work is based on the periodic release of doses of a hormone that upsets the standard changes in the female body that pregnancy brings. The state in which the body finds itself after using drugs is called menstrual chaos .
You need to understand that such a technique can only work once, after a single sexual intercourse without protection. In no case can this serve as a means of regular birth control. On the one hand, the effectiveness of postcoital contraception, and on the other hand, the harm to the body may be incomparable compared to the use of other means.
The very effectiveness of postcoital contraception depends on the moment at which copulation occurred. For the menstrual cycle, it is 74-100% if used immediately after intercourse, and 70-93% if used during the periovulatory and/or ovulatory period .
In what cases should you not use 72 hour tablets?
The main indication for using 72-hour birth control pills is to prevent pregnancy. They are not suitable for abortion; contraceptives cannot cause an abortion after implantation of the embryo. Contraceptives with levonorgestrel are contraindicated for:
- pregnancy;
- allergies to any component of the drug;
- severe liver failure;
- some hereditary diseases associated with lactase deficiency;
- malabsorption syndrome.
Mifepristone should not be used in the following conditions:
- early ectopic pregnancy;
- long-term treatment with corticosteroids;
- bleeding from the vagina;
- anemia and blood clotting pathology.
Can be used with caution for bronchial asthma, hypertension and heart failure.
Contraindications for postcoital contraception
Of course, any specialist will analyze the condition of your body before choosing a specific drug, but you should also know about the existing contraindications for postcoital contraception .
Thus, the methods described in this article should be discontinued if the patient has renal failure , a drug allergy to any of the components of the drug, or severe asthma
There is no point in using medications even if the fact of pregnancy is not confirmed. The fact that sexual intercourse took place without contraceptives does not provide a 100% guarantee that a woman will become pregnant. If the fact of conception is confirmed, but there is a suspicion that the pregnancy is ectopic , the use of drugs should also be discontinued, due to the fact that they are designed to act specifically on the muscular layer of the uterus.
Adverse reactions
Pills to terminate a possible pregnancy within 72 hours can be harmful even if the dosage is followed. Possible adverse reactions may include:
- uterine bleeding;
- aching pain in the lower abdomen;
- headache;
- bowel dysfunction, nausea;
- dysmenorrhea, delayed menstruation.
It is not recommended to combine contraceptives with alcohol and other hormonal drugs, as well as some antibiotics.
Mechanism of action - how does the tablet work 5 days later?
“The 5-day pill” is a pharmacological (hormonal) remedy indicated in case of unprotected sexual intercourse or refusal of a contraceptive method, to reduce the likelihood of unwanted pregnancy. In Europe, the medicine is sold under different names, for example, ellaOne. As of 2021, this option is included in the World Health Organization's list of essential medicines for this indication.
Pharmacological (hormonal) agent ellaOne®
“Pill after 5 days” is based on the active ingredient – ulipristal acetate. From a pharmacological point of view, this active ingredient belongs to the category of antiprogestins, that is, molecules that counteract the action of progesterone, a hormone fundamental to creating conditions suitable for fertilization and implantation.
Ulipristal acetate binds with high affinity to the progesterone receptor in an attempt to suppress or delay eventual ovulation by suppressing the rise in luteinizing hormone (LH) levels. Thus, the “after 5 day pill” prevents the fertilization of the egg released from the ovaries through the tubes and the sperm from reaching the uterus.
